1549例患儿莲必治注射液应用合理性分析及药物利用研究

Rational Application and Drug Utilization of Lianbizhi Injection in 1549 Children

目的:探讨莲必治注射液在儿童患者中的应用合理性以及中药注射剂在儿童患者中的药物利用研究。方法:对2018年某儿童医院应用莲必治注射液的住院患儿资料进行回顾性分析,结合药品说明书以及患儿年龄、体质量,对给药剂量、给药浓度、用药频次及溶剂选择等方面进行统计分析;计算儿童药物利用指数,初步探讨中药注射剂在儿童患者中的合理评价方法。结果:最终纳入1549例患儿,合理性评分均值为5.43分;适应证合理率最低,仅为45.32%(702/1549);给药浓度均值超过规定范围(0.8~1.5 g/L),最小浓度为0.2 g/L,最大浓度达6.25 g/L。年龄方面,≤1岁患儿的儿童药物利用指数-剂量(cdDUI)>1.1,而>4岁患儿的cdDUI<0.9,不同年龄段患儿的儿童药物利用指数-浓度(ccDUI)均>1,尤以≤6个月为著。体质量方面,≤30 kg患儿的儿童药物利用指数(cDUI)均>1.1,而>30 kg患儿的cDUI均<0.9。结论:从年龄、体质量和平均给药剂量、药物利用指数可见,均存在低年龄或低体重患儿莲必治注射液用药量大,而高年龄或高体质量患儿用药量不足的现象,且均存在给药浓度过高的现象。因此,应加强中药注射剂在儿童中应用的合理性评价。

OBJECTIVE:To explore the application rationality of Lianbizhi injection in children and the drug utilization of traditional Chinese medicine injection in children.METHODS:Retrospective analysis was conducted on clinical data of hospitalized children with Lianbizhi injection in a children’s hospital in 2018.Combined with the drug instructions,age and body mass of the children,dose,concentration and frequency of administration,solvent selection were statistically analyzed.The drug utilization index was calculated to explore the rational evaluation method of traditional Chinese medicine injection in children.RESULTS:Totally 1549 children were enrolled,the average rationality score was 5.43.And the compliance rate of indications was the lowest,only 45.32%(702/1549).The mean dose concentration exceeded the prescribed range(0.8-1.5 g/L),the minimum concentration was 0.2 g/L,and the maximum concentration was 6.25 g/L.Children’s drug use index-dose(cdDUI)>1.1 was found in children aged from 0 to 1 years,while cdDUI<0.9 was found in children aged over 4 years.Children’s drug use index-concentration(ccDUI)in children of different ages were all>1,especially those aged≤6 months.The drug use index(cDUI)of children with body mass≤30 kg was all>1.1,while the cDUI of children with body mass>30 kg were all<0.9.CONCLUSIONS:It can be seen from the age,body mass,average dose and drug utilization index that children with lower age or lower body mass have a large dose of Lianbizhi injection,while children with higher age or higher body mass have a low dose of Lianbizhi injection,and the drug concentration is too high.Therefore,the application rationality of traditional Chinese medicine injections in children should be strengthened.